Provider Demographics
NPI:1962591172
Name:FLANDRY, AMY MEGGS (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MEGGS
Last Name:FLANDRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-6617
Mailing Address - Fax:
Practice Address - Street 1:101 E WOOD ST STE 401
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3040
Practice Address - Country:US
Practice Address - Phone:864-560-6654
Practice Address - Fax:864-560-7353
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063418207R00000X
SCLL29081207R00000X
SCMD 29081207R00000X
SC29081208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG63418Medicaid
GA798096569AMedicaid
SCP01252951OtherRAILROAD MEDICARE
NC5922630Medicaid
SCPO1234503OtherRAILROAD MEDICARE
NC5922630Medicaid
SCAA93529068Medicare PIN
SCAA93525019Medicare PIN
GA202I118748Medicare PIN